Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN11012860 | FL |
NPI | 1023783297 |
---|---|
Provider Name | Molly Catherine Gorman |
First Address | St Petersburg, FL 33713-2305 |
Second Address | Tampa, FL 33606-3571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2021 |
Last Update Date | 10/08/2021 |